Chamber and committees

NHS boards are responsible for the planning and provision of NHS services in accordance with national and local priorities, based on their assessment of the health needs of their resident populations, and in line with guidance on evidence-based care for specific diseases or conditions. Such guidance is available from a range of sources, including NHS Quality Improvement Scotland.

The Arbuthnott Formula allocates resources to NHS boards according to the needs of and costs of supplying services to their populations. The additional needs indices in the formula are built up from care programmes and diagnostic groups, and are not based on the prevalence of specific conditions.

The Information Services Division (ISD) of NHS National Services Scotland has set up a long-term conditions programme to tackle this issue, with a particular emphasis on record linkages as the basis of a person-centred approach that will capture co-morbidities. The Chief Medical Officer’s Long-Term Conditions Steering Group receives regular reports from those responsible for the programme.

ISD is working closely with five Community Health Partnerships to understand their information needs, particularly in relation to long term conditions. There is a recognition of the need to link to work on community care outcomes and the single shared assessment to provide a holistic approach.

Long-term conditions have also been identified as an important element of the eHealth strategy.

In relation to Parkinson’s disease, the development of the clinical guideline by SIGN and clinical standards by NHS Quality Improvement Scotland will act as a catalyst for data collection.

The most recent assessment of the cost of alcohol misuse in Scotland comes from work carried out in 2004-05 by the Scottish Executive. They estimated the cost to society of alcohol misuse in 2002-03 as being in the region of £1.1 billion. This assessment updated the costs and methodology developed in the 2001 Scottish Executive report Cost of Alcohol Misuse in Scotland Trends and Costs. The 2001 report estimated the cost of alcohol misuse to be £1 billion.

The Scottish Government is currently updating these earlier estimates. It is anticipated that the full updated estimates will be published soon. A copy will be sent to the member on publication.

The most recent assessment of the cost of smoking to the economy and the NHS was published in a report commissioned by the Scottish Executive, Reducing Smoking and Tobacco-Related Harm (2003). It is estimated that the annual cost of smoking-related time off work in Scotland is £40 million and total productivity losses are put at £450 million. Smoking is estimated to cost NHS Scotland £200 million a year in hospital care. There has been no assessment of the costs of smoking to primary care services.

Robust estimates of the economic and social impacts of illicit drugs in Scotland are not currently available, but based on research from England and Wales the total costs to society are likely to amount to around £2.6 billion per annum. A research project is currently in progress to produce an initial estimate of the size and value of illicit drug markets in Scotland, and of the economic and social costs associated with illicit drug use. The research will also consider the value of extending the estimates to cover alcohol abuse and tobacco consumption, and is due to be completed later this year.

There is a wide range of publicly funded activity to tackle alcohol misuse, smoking and illicit drug use and it is not known centrally how much in total is spent on such activities. The following table shows specifically identifiable spend by the Scottish Government in each year since 2005-06 and in each of the next three years in tackling alcohol misuse, smoking and illicit drug use.

	2005-06 (£ Million)	2006-07 (£ Million) >	2007-08 (£ Million) >	2008-09 (£ Million) >	2009-10 (£ Million) >	2010-11 (£ Million) >
Smoking	8.0	10.0	11.5	14.0	14.0	14.0
Alcohol Misuse	12.1	12.1	12.4	30.4	43.4	48.4
Illicit drug use	31.2	31.3	31.7	29.5	32.0	32.8

Notes:

This table does not include £2 million per annum for tackling smoking, which is now part of NHS boards'' unified budgets; NRT prescribing (costs approx £7 million per annum) or NHS Health Scotland''s tobacco programme budget (approx £1 million per annum).

From 2008-09 the budget for enforcing smoke-free (£2.5 million in 2007-08) is provided by means of a block grant.

The alcohol misuse funding within this table is that made specifically available for this purpose by the Scottish Government. Significant additional resources are likely to have been made available by NHS boards and local authorities.

The 2007-08 figure for tackling illicit drug use is not directly comparable with 2008-09. In addition to the funding available for tackling drug misuse in the Justice portfolio, a number of other budgets also provide resources for tackling drug misuse including local government, the police and NHS boards'' unified budgets.

The information is contained in the following table:

Council Tax Collection (Including Council Tax Discounts and Community Charge Residual Costs) Net Revenue Expenditure (£000)

	2002-03	2003-04	2004-05	2005-06	2006-07
Scotland	37,294	37,551	36,507	38,346	40,541
Aberdeen City	1,448	2,295	1,819	1,771	1,315
Aberdeenshire	2,775	2,858	2,248	2,666	1,394
Angus	1,092	1,407	1,095	1,097	1,296
Argyll and Bute	531	672	665	750	697
Clackmannanshire	170	112	113	116	282
Dumfries and Galloway1	885	-222	1,180	1,775	1,540
Dundee City	2,807	2,800	2,930	3,446	3,056
East Ayrshire	814	864	874	865	896
East Dunbartonshire	241	231	285	565	404
East Lothian	549	553	566	499	487
East Renfrewshire	204	263	325	333	263
Edinburgh City	1,379	1,663	1,455	1,308	4,738
Eilean Siar	304	358	387	463	356
Falkirk	70	102	34	106	14
Fife	1,873	2,150	2,176	1,538	2,426
Glasgow City	8,030	7,561	8,439	6,541	7,903
Highland	1,683	1,950	1,945	1,723	1,877
Inverclyde	427	468	286	450	210
Midlothian	598	770	637	816	823
Moray	742	849	780	791	848
North Ayrshire	702	898	756	1,275	956
North Lanarkshire	1,727	2,623	1,544	2,313	2,050
Orkney Islands	127	108	130	180	200
Perth and Kinross	1,107	1,268	1,202	1,172	860
Renfrewshire	814	868	772	852	946
Scottish Borders	246	320	298	930	749
Shetland Islands	163	217	156	219	209
South Ayrshire	682	975	558	750	111
South Lanarkshire	2,507	1,986	1,651	1,727	2,329
Stirling	326	254	109	267	392
West Dunbartonshire2	1,564	-39	456	330	194
West Lothian	707	369	636	712	720

Source: As reported by local authorities on the statistical return LFR 9 Central Services .

Notes:

1. Dumfries and Galloway''s credit figure is 2003-04 due to recovery of cumulative surcharges for previous years

2. West Dunbartonshire''s credit figure in 2003-04 is due to income generated from sales/rents/fees/charges exceeding costs debited to the account.

NHS boards will manage the disbursement of the Governments'' Transition Fund to individual healthy living centres (HLC). Funding will be provided for HLCs that have good prospects for achieving sustainability beyond the transition funding and continue to have the support of their local partners. The level of transition funding provided for each healthy living centre will not exceed £100,000.

So far, funding has been allocated to NHS Fife and NHS Greater Glasgow and Clyde for HLCs in their area.

The following table outlines how much funding local authorities have been allocated for cycling, walking and safer streets projects in 2008-09, 2009-10 and 2010-11. Although local authorities are able to spend their CWSS allocation on safer routes to schools, additional funding for tackling the school run projects is awarded to Sustrans who allocate to local authorities through a bidding process.

	2008-09	2009-10	2010-11
	£ Million
Aberdeen City	0.365	0.365	0.365
Aberdeenshire	0.412	0.412	0.412
Angus	0.191	0.191	0.191
Argyll and Bute	0.163	0.163	0.163
Clackmannanshire	0.086	0.086	0.086
Dumfries and Galloway	0.262	0.262	0.262
Dundee City	0.249	0.249	0.249
East Ayrshire	0.212	0.212	0.212
East Dunbartonshire	0.191	0.191	0.191
East Lothian	0.170	0.170	0.170
East Renfrewshire	0.165	0.165	0.165
Edinburgh, City of	0.818	0.818	0.818
Eilean Siar	0.045	0.045	0.045
Falkirk	0.267	0.267	0.267
Fife	0.639	0.639	0.639
Glasgow City	1.021	1.021	1.021
Highland	0.374	0.374	0.374
Inverclyde	0.146	0.146	0.146
Midlothian	0.149	0.149	0.149
Moray	0.154	0.154	0.154
North Ayrshire	0.241	0.241	0.241
North Lanarkshire	0.579	0.579	0.579
Orkney	0.034	0.034	0.034
Perth and Kinross	0.247	0.247	0.247
Renfrewshire	0.304	0.304	0.304
Scottish Borders	0.196	0.196	0.196
Shetland	0.040	0.040	0.040
South Ayrshire	0.199	0.199	0.199
South Lanarkshire	0.544	0.544	0.544
Stirling	0.160	0.160	0.160
West Dunbartonshire	0.164	0.164	0.164
West Lothian	0.303	0.303	0.303
Total	£9.09 million	£9.09 million	£9.09 million

 

Management of the Transmission Network in this area is primarily a matter for Scottish and Southern Energy and National Grid. We understand that there is interest in increased generation opportunities in the area, although the current system only provides limited potential for exporting electricity. Scottish and Southern Energy are currently reviewing transmission solutions to try to release additional capacity on this network. The Scottish Government is in contact with Scottish and Southern Energy on this issue and will meet National Grid very shortly.

Information on the number of hospital admissions due to cycling accidents in each of the last five years is shown in table 1, while table 2 shows the number of deaths due to cycling accidents.

Table 1. Number of Hospital Episodes as a Result of a Cycling Accident by NHS Board of Residence; for All Ages and Children; for all Injuries and only Head Injuries; for Financial Years of Discharge 2002-03 to 2006-07

NHS Board of Residence >	2002-03				2003-04
	All Ages		Children		All Ages		Children
	All Injuries	Head Injuries	All Injuries	Head Injuries	All Injuries	Head Injuries	All Injuries	Head Injuries
Ayrshire and Arran	94	35	57	25	102	49	62	33
Borders	32	12	22	11	19	13	13	8
Dumfries and Galloway	31	11	15	7	27	8	12	3
Fife	78	36	53	28	74	30	52	23
Forth Valley	56	24	37	17	60	26	40	21
Grampian	166	84	106	60	205	102	124	70
Greater Glasgow and Clyde	195	82	130	64	212	98	141	77
Highland	99	40	46	19	109	48	51	25
Lanarkshire	92	40	66	31	115	45	82	34
Lothian	147	53	89	39	156	56	88	33
Orkney	6	4	5	3	2	2	2	2
Shetland	12	7	9	6	4	1	3	-
Tayside	70	27	38	16	89	29	44	15
Western Isles	8	3	5	3	7	3	4	2
Scotland	1,086	458	678	329	1,181	510	718	346

 

NHS Board of Residence >	2004-05				2005-06
	All Ages		Children		All Ages		Children
	All Injuries	Head Injuries	All Injuries	Head Injuries	All Injuries	Head Injuries	All Injuries	Head Injuries
Ayrshire and Arran	101	44	54	32	87	35	55	26
Borders	31	19	19	12	25	11	12	6
Dumfries and Galloway	34	9	18	6	24	5	10	2
Fife	91	40	51	27	56	22	32	17
Forth Valley	74	40	53	31	70	28	51	22
Grampian	172	100	108	77	167	78	95	53
Greater Glasgow and Clyde	163	65	89	41	163	76	87	50
Highland	117	56	54	29	78	26	40	15
Lanarkshire	60	18	45	14	74	30	57	24
Lothian	173	56	93	41	189	62	105	44
Orkney	8	2	6	-	7	3	3	2
Shetland	2	-	2	-	1	1	-	-
Tayside	86	34	42	16	68	21	34	14
Western Isles	1	1	-	-	4	2	2	1
Scotland	1,113	484	634	326	1,013	400	583	276

 

NHS Board of Residence >	2006-07
	All ages		Children
	All Injuries	Head Injuries	All Injuries	Head Injuries
Ayrshire and Arran	91	27	54	20
Borders	41	17	22	8
Dumfries and Galloway	32	7	10	1
Fife	78	34	40	19
Forth Valley	54	26	30	18
Grampian	146	59	77	46
Greater Glasgow and Clyde	151	60	77	40
Highland	114	53	49	31
Lanarkshire	78	25	46	17
Lothian	165	77	76	42
Orkney	5	1	2	1
Shetland	3	1	1	1
Tayside	101	35	50	19
Western Isles	6	4	3	2
Scotland	1,065	426	537	265

 

Table 2. Number of Deaths as a Result of a Cycling Accident by NHS Board of Residence; for All Ages and Children; for Calendar Years 2002 to 2006

NHS Board of Residence >	2002		2003		2004
	All Ages	Children	All ages	Children	All ages	Children
Ayrshire and Arran	-	-	2	1	-	-
Borders	-	-	-	-	-	-
Dumfries and Galloway	1	-	-	-	-	-
Fife	2	-	1	-	1	-
Forth Valley	-	-	-	-	1	-
Grampian	1	-	4	-	-	-
Greater Glasgow and Clyde	1	-	1	-	-	-
Highland	2	-	3	-	-	-
Lanarkshire	1	-	-	-	-	-
Lothian	1	-	2	-	2	-
Orkney	-	-	-	-	-	-
Shetland	-	-	-	-	-	-
Tayside	-	-	2	-	1	-
Western Isles	-	-	-	-	1	-
Scotland	9	-	15	1	6	-

 

NHS Board of Residence	2005		2006
	All Ages	Children	All Ages	Children
Ayrshire and Arran	-	-	-	-
Borders	-	-	1	-
Dumfries and Galloway	1	-	1	-
Fife	-	-	-	-
Forth Valley	-	-	-	-
Grampian	4	2	3	-
Greater Glasgow and Clyde	5	-	3	3
Highland	1	-	-	-
Lanarkshire	3	1	1	1
Lothian	-	-	1	1
Orkney	-	-	-	-
Shetland	-	-	-	-
Tayside	1	1	1	-
Western Isles	1	-	-	-
Scotland	16	4	11	5

 

As local authorities have a general duty to deal with emergencies there is no automatic entitlement to special financial assistance. In exceptional circumstances, however, local authorities can apply under the Bellwin Scheme for additional revenue funding to assist with the immediate and unforeseen costs in dealing with the aftermath of emergency incidents.

Full details of the Bellwin Scheme can be found on the Scottish Government website at:

http://www.scotland.gov.uk/Topics/Government/local-government/17999/Bellwin.